title: Topical paromomycin/methylbenzethonium chloride plus parenteral meglumine antimonate as treatment for American cutaneous leishmaniasis: controlled study.
abstract: We determined the efficacy of the combination of the topical formulation 15% paromomycin sulfate/12% methylbenzethonium chloride (MBCL) and a short course (7 days) of parenteral meglumine antimonate (pentavalent antimony [Sb]) as treatment of American cutaneous leishmaniasis in Colombian patients. Patients were randomly assigned in unequal allocation (2:1:1:1) to group 1 (topical paromomycin/MBCL plus injectable Sb for 7 days), group 2 (topical placebo plus injectable Sb for 7 days), group 3 (topical paromomycin/MBCL plus injectable Sb for 3 days), and group 4 (injectable Sb for 20 days). Cure was defined as complete reepithelialization of all lesions without relapse. Cure rates among groups were as follows: 58% (34 of 59), group 1; 53% (16 of 30), group 2; 20% (6 of 30), group 3; and 84% (26 of 31), group 4. Seventy-one percent of the organisms identified to the species level were Leishmania braziliensis panamensis. We conclude that 10 days of therapy with paromomycin/MBCL does not augment the response of cutaneous leishmaniasis (predominately due to L. braziliensis panamensis) to a short course of treatment with meglumine antimonate.
authors.affiliation: Universidad Militar Nueva Granada, CIMPAT-Universidad de los Andes, Bogota, Colombia.
authors.forename: J
authors.initials: J
authors.lastname: Soto
authors.forename: P
authors.initials: P
authors.lastname: Fuya
authors.forename: R
authors.initials: R
authors.lastname: Herrera
authors.forename: J
authors.initials: J
authors.lastname: Berman
mesh_terms: D000981:Antiprotozoal Agents / Q000008:administration & dosage*; D001558:Benzethonium / Q000008:administration & dosage / Q000031:analogs & derivatives*; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D006801:Humans; D016773:Leishmaniasis, Cutaneous / Q000188:drug therapy*; D008536:Meglumine / Q000008:administration & dosage*; D000077485:Meglumine Antimoniate; D009942:Organometallic Compounds / Q000008:administration & dosage*; D010303:Paromomycin / Q000008:administration & dosage*
chemical_list: D000981:Antiprotozoal Agents; D009942:Organometallic Compounds; D001558:Benzethonium; D010303:Paromomycin; D008536:Meglumine; D000077485:Meglumine Antimoniate; C005106:methylbenzethonium chloride